Environmental exposures linked to childhood disease

One quarter of the global disease burden in adults is related to environmental risk factors that could be modified with existing interventions, the World Health Organization (WHO) said in a new report on June 16. And in the case of children, environmental factors are involved in more than one-third of the disease burden, said Carlos Corvalán, coordinator of WHO's department of public health and environment and co-author of the report. However, "the positive message is that we know which type of interventions need to be done in order to reduce that burden of disease and make sure that our health will benefit," said María Neira, WHO director of public health and environment. "We are talking about interventions that are available," said Neira "We are talking about reducing air pollution indoors and outdoors, about better access to clean water, about the prevention of chronic acute respiratory infections through the use of better fuels, about even the prevention of some non-communicable diseases such as cancer by regulating exposure to certain chemicals or improving the working environment and making sure that all of these will be contributing to our health." The WHO is thus calling on environmental policymakers, industry, energy, transport and the health sector to work towards the objective of making "wise investments" in terms of the environment, in order to prevent health problems related to environmental factors, she added. The report "points to a lot of inequalities, and by knowing where the problems are, we know where to act," said Corvalán. Children overall suffer a greater impact from environmental hazards that could be averted. But in the developing world, there are 12 times more deaths of children caused by environmental exposures than in rich countries. The problem, however, is much worse after looking at healthy years of life lost in children in the poorest regions of the world, compared with more prosperous regions, said Corvalán. "You find a difference of 25 times higher road traffic injures, 145 higher diarrheal diseases in children, eight times higher respiratory infections." Neira noted that the WHO's environmental health recommendations are closely linked to the eight Millennium Development Goals (MDGs), concrete targets that were adopted by the international community in 2000 to fight global problems like poverty, hunger, illiteracy and disease. For example, reducing to a minimum exposure to environmental risk factors indirectly contributes to the first MDG, which proposes halving extreme poverty and hunger by 2015, from 1990 levels, said Neira. Environmentally-caused diseases often lead to loss of income by leaving productive members of a family chronically ill, disabled or dead, thus affecting entire households, she pointed out. The problem is also linked to the second MDG, focused on achieving universal primary education. Simply providing clean drinking water and latrines or toilets in schools, including separate facilities for girls, keeps children in school, Neira observed. Worldwide, environmental interventions could prevent the deaths of more than two million children under five every year, thus making major progress towards the fourth MDG: reducing infant and under-five mortality by two-thirds between 1990 and 2015. Although the eight MDGs are all closely related to the WHO plan on "Preventing Disease Through Healthy Environments"–the title of the report–that link is most obvious in the case of the seventh goal, guaranteeing environmental sustainability. The experts noted that some 1.7 million deaths a year are caused by diarrhoeal diseases associated with lack of clean water and adequate sanitation. Indoor pollution from household use of firewood and coal, meanwhile, causes 1.5 million deaths a year from respiratory infections. Neira cited the cases of diarrhea and lower respiratory infections, two of the main causes of death among children in Africa. The WHO report estimates that more than 13 million deaths a year are caused by preventable environmental factors, and that nearly one-third of death and disease in the world's poorest regions are due to environmental causes. Furthermore, over 40 percent of deaths caused by malaria and 94 percent of deaths from diarrhea "could be prevented through better environmental management," it adds. Acting WHO Director-General Anders Nordström said: "We have always known that the environment influences health very profoundly, but these estimates are the best to date. This will help us to demonstrate that wise investment to create a supportive environment can be a successful strategy in improving health and achieving development that is sustainable."